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Release Waiver

Radiology Associates of Hartford, PC is committed to preventing sick employees, physicians, students, vendors, or contractors from entering the workplace and when recognized, be instructed to leave if they become ill.

Your e-signature indicates you are attesting before entering a RAH facility, you are not experiencing any of the following symptoms:

A new fever (100.4 or higher) or a sense of having a fever
A new cough that you cannot attribute to another health condition
New shortness of breath that you cannot attribute to another health condition

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Your legal name

Your email address

Please Confirm full name and signature.

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July 9, 2020 11:50 pm EST

Release Waiver Uploaded by Kathy Smith - COVID19@rahxray.com IP 71.218.111.163